The overarching goal of the proposed research program is to develop a foundation of knowledge and to motivate design of systems and instruction to meet the needs and capabilities of users of medical devices and equipment. The research will investigate human factors issues of video- mediated, remote managed care, information delivery of instruction and warning information, use of medical devices, and medically-based instruction and training. As such, the research will further basic understand and knowledge of issues of skill, acquisition, transfer, and retention; training; and optimum information transmission techniques. The research will address fundamental problems that potentially affect individuals' health and well-being when interacting with medical devices and equipment. Research outcomes will provide design and instruction intervention strategies for specific medical technologies, will broaden the scope of knowledge, and augment our understanding of human factors issues of health care needs that extend beyond the specific devices identified within the experiments. The present research and development effort will improve knowledge for the principled development of age related system design and enhance basic understanding of cognition for both older and young adults in relatively complex, rich task domains. The data from the laboratory and field tests will allow formulation of a model of age-related task interaction for complex tasks to address the important issue of scale of complexity in psychological theory. The proposed program of research will create a road map that all other human factors research in this domain may follow. The proposed effort will create fundamental knowledge as well as intervention principles that will provide a more complete picture of the broad area of medical system design and the older adult. This work will help char the course for human factors success in medical systems design.